Optometry in India- Optom. Rajesh Wadhwa M.Optom B.Ophth.Tech.(Hons.) AIIMS B.Sc.(Hons.) DU Fellow of International Association of Contact Lens Educators

Optometry in Optometry in India-India-

Optom. Optom. Rajesh Rajesh WadhwaWadhwa

M.OptomM.OptomB.Ophth.Tech.(Hons.) AIIMSB.Ophth.Tech.(Hons.) AIIMS

B.Sc.(Hons.) DUB.Sc.(Hons.) DUFellow of International Association of Contact Lens Educators (Australia)Fellow of International Association of Contact Lens Educators (Australia)

PGDHRM (IGNOU)PGDHRM (IGNOU)

where do we where do we stand?stand?

Rajesh Wadhwa- New Delhi

[email protected]:09868010187

What do we see in a What do we see in a process....process....

We see what the mind wishes to We see what the mind wishes to appreciateappreciateAn

Intellectual sees

Public health

professional sees

Corporate sees

opportunity

Optometry has rewards

for all…

-Society

--Universities

--- Country

----Corporate

----- Hospitals



When the knowledge of When the knowledge of profession and willfull profession and willfull effort of all will flow in effort of all will flow in

the countrythe country

…. Country will also save US$ 23 billion per year through

eye-care

In addition to

improving quality of

life for many…..



World has….World has….

37 Million blind37 Million blind India owns 15millionIndia owns 15millionVisually impaired in Visually impaired in

world=133million world=133million India owns 52 millionIndia owns 52 million

Poverty & blindness

encourage each other



What is the cost to What is the cost to country?country?

We can save hereWe can save hereIndia: the loss of India: the loss of productivity & economic productivity & economic burden of maintenance burden of maintenance is is over $23 billion per yearover $23 billion per year



Monetary loss is Monetary loss is not the real not the real

pain ....pain .... .... about 85% of all vision .... about 85% of all vision impairment and 75% of blindness impairment and 75% of blindness globally globally could be avoided, could be avoided, prevented or cured prevented or cured (need personnel, facilities)(need personnel, facilities)

This is where optometry is eager This is where optometry is eager to share the responsibilityto share the responsibility

Do we know?

NPCB partnering with

other agencies is doing

a commendable job to

eliminate the “needless

blindness” by year 2020



IndiaIndia Main cause of visual impairment is Main cause of visual impairment is

““unoperated cataractunoperated cataract” (72L) & ” (72L) & ““uncorrecteduncorrected refractive errorrefractive error” (24L)” (24L)

We have only about 6000 surgically We have only about 6000 surgically active ophthalmologists (general active ophthalmologists (general perception)perception)

We need another professional to do We need another professional to do non-surgical work in eye-carenon-surgical work in eye-care

Answer is “Answer is “OptometristOptometrist” (we are ” (we are 40,000+)40,000+)

Who is an optometri

st ?



WHO throughWHO throughWorld Council of World Council of

OptometryOptometry Classifies Optometry as an Classifies Optometry as an independent independent

primary health-care professionprimary health-care profession And defines optometrists as And defines optometrists as 'the primary 'the primary

healthcare practitioners of the eye and healthcare practitioners of the eye and visual system who provide visual system who provide comprehensive eye and vision care, comprehensive eye and vision care, which includes refraction and which includes refraction and dispensing, the detection/diagnosis dispensing, the detection/diagnosis and management of diseases in the and management of diseases in the eye, and the rehabilitation of eye, and the rehabilitation of conditions of the visual system”conditions of the visual system”



Questions regarding Questions regarding optometry todayoptometry today

What can optometry offer in eye care ?What can optometry offer in eye care ? What can an optometrist do to relieve What can an optometrist do to relieve

the time of ophthalmologist ?the time of ophthalmologist ? Is optometrist different from optician ?Is optometrist different from optician ? Who represents optometry in India for any Who represents optometry in India for any

policy?policy? How will society, universities, How will society, universities,

country,health care system & corporate country,health care system & corporate world benefit from growth of optometry?world benefit from growth of optometry?Next slide is a busy-

slide



What can an optometrist What can an optometrist do as an independent do as an independent

practitioner practitioner Other fields include:Other fields include: Spectacle dispensingSpectacle dispensing Spread public Spread public

awareness about awareness about common eye common eye conditions, their conditions, their treatment and the treatment and the need for regular eye need for regular eye check-up check-up

Timely referral of Timely referral of patients where patients where medical/surgical medical/surgical intervention is intervention is required required

Low Vision Aids, assistive vision devices

& rehabilitation

Refraction Contact Lenses

Childhood blindness Orthoptics ,

& pre/post op co-management

Tonometry,

fields,

A-scan etc.



An optometrist..An optometrist..…….is able to deliver .is able to deliver appropriate level of appropriate level of high quality eye carehigh quality eye care from the small clinic or from the small clinic or practice in remote practice in remote region as a stand-alone region as a stand-alone vision care and eye vision care and eye health expert health expert



e.g. in my small practice of 10 new e.g. in my small practice of 10 new cases a day : We detect-by looking cases a day : We detect-by looking

at eyesat eyes

1/wk we detect a new hypertensive1/wk we detect a new hypertensive 1/wk we detect a new diabetic1/wk we detect a new diabetic 1/mth we detect glaucoma 1/mth we detect glaucoma

(3 suspect)(3 suspect) 1 in 2yrs we detect lesions at higher 1 in 2yrs we detect lesions at higher

centerscenters



Why is optometrist a Why is optometrist a health care professionalhealth care professional Diagnose conditions due to systemic Diagnose conditions due to systemic

diseases and refer patients to other diseases and refer patients to other health practitioners as needed.health practitioners as needed.

This integrates optometrist with This integrates optometrist with rest of health-care systemrest of health-care system

Hong Kong, Malaysia, Mauritius, Hong Kong, Malaysia, Mauritius, Philippines, US, UK,Australia, Canada Philippines, US, UK,Australia, Canada are some countries where the use of are some countries where the use of diagnostic drugs is now permitted to diagnostic drugs is now permitted to qualified optometrists qualified optometrists

Overcoming obstacles

in Outreach

Socially optometrist is

first point of contact &

therefore first line of

defense against

blindness



Organization of eye-careOrganization of eye-care

Ophthalmologist represents Ophthalmologist represents the highest level of eye-the highest level of eye-care-provider in Indiacare-provider in India

We have optometrist & We have optometrist & opticians alsoopticians also



India-in a process at this India-in a process at this time time

Every one does almost Every one does almost everythingeverything

OpticianOptician dispenses dispenses spects….ALSO prescribes spects….ALSO prescribes spects & fits contact spects & fits contact lenseslenses

OptometristOptometrist does does orthoptics, investigations, orthoptics, investigations, prescribing spects, prescribing spects, contact lenses etc, also contact lenses etc, also manages minor eye-manages minor eye-ailments & runs optical ailments & runs optical outletsoutlets

OphthalmologistOphthalmologist practices medicine & practices medicine & surgery ….AND does surgery ….AND does orthoptics, refractions & orthoptics, refractions & runs optical outletsruns optical outlets

OphthalmologistsOpticians

Optometri

st



In countries with mature In countries with mature eye-care systemeye-care system

In USA &

Australia,

approx 70%

of all eye care

is provided by

optometrists



In countries with mature In countries with mature eye-care systemeye-care system

In India “ophthalmic

assistant” is not this level of professional. “Optometrist” is sometimes called ophthalmic assistant in India

In India when quality students qualify,

some tend to move to countries where optometry is a

recognized profession (in USA this is 4th most preferred

profession)



As optometry As optometry professionalsprofessionals

Our Our primary public health primary public health responsibility is to eliminate responsibility is to eliminate uncorrected refractive error uncorrected refractive error (URE).(URE).

In national interest: In national interest: It costs so It costs so much less time, money & resource much less time, money & resource to train an optometrist than to to train an optometrist than to train an ophthalmologist for non-train an ophthalmologist for non-medicinal work (e.g. Refraction, medicinal work (e.g. Refraction, contact lens, orthoptics etc) contact lens, orthoptics etc)

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As optometrists- we are a As optometrists- we are a major component of major component of

solutionsolution We stand united We stand united in strength of in strength of

40,000+ to fight the problem by 40,000+ to fight the problem by getting involved in national policiesgetting involved in national policies

NO CONFUSIONNO CONFUSION: the earlier : the earlier confusion of who represents confusion of who represents “optometry” & who represents “optometry” & who represents “education in optometry” is “education in optometry” is resolvedresolved



With help of several With help of several agencies “Delhi agencies “Delhi

declaration” was signed declaration” was signed in Jul.2010……in Jul.2010……

DELHI DECLARATION ON OPTOMETRYAND BLINDNESS PREVENTION IN INDIA



Example of Example of commitments commitments

(out of 11)(out of 11) Assisting in the development and provision Assisting in the development and provision of accessible, affordable and excellent of accessible, affordable and excellent vision care services to vision care services to all people of India – all people of India – regardless of their geographical location or regardless of their geographical location or socio-economic statussocio-economic status (public:priv=10:90) (public:priv=10:90)

Developing competent human resources in Developing competent human resources in Optometry to meet the Optometry to meet the current and futurecurrent and future eye care needs and reduce the burden of eye care needs and reduce the burden of vision impairment and blindness in India vision impairment and blindness in India (mango tree)(mango tree)



We have created the baseWe have created the base

Any agency now needs to talk only to Any agency now needs to talk only to one organization regarding one organization regarding “optometry” in India“optometry” in India

Indian Optometry Indian Optometry Federation (IOF)Federation (IOF)

Education in optometryEducation in optometryASCO ASCO (Association Of Schools & Colleges Of Optometry)(Association Of Schools & Colleges Of Optometry)



Is a registered bodyIs a registered body Has membership of VISION 2020Has membership of VISION 2020 Is voice of all (40000+ optometrist)Is voice of all (40000+ optometrist) Is working towards partnership with Is working towards partnership with

Govt., NGOs and international Govt., NGOs and international agencies to standardize & regulate agencies to standardize & regulate optometryoptometry

Is committed to Delhi DeclarationIs committed to Delhi Declaration



NPCBNPCBIn India A In India A National National Programme for Programme for control of control of Blindness was Blindness was started in 1975 started in 1975 with the motto with the motto that that

‘‘OneOne of the basic of the basic Human rights is Human rights is the right to see,the right to see,……”……”

At IOF we have adopted one single

nomenclature “Optometrist” for

all 2 years or higher (4,6,11 yr)

qualifications



Public health Public health contribution of contribution of

optometry can not be optometry can not be overlookedoverlooked

AsAs individual practitionersindividual practitioners institutional professionalsinstitutional professionals schools of optometryschools of optometry

Also done work inAlso done work in school vision screening, cataract school vision screening, cataract

screening, special children screening, screening, special children screening, etc.etc.

Next 2 slides show an example of success with optometry involvement in national programs



OPTOMETRISTS to OPTOMETRISTS to OPHTHALMOLOGISTSOPHTHALMOLOGISTS

CountriesCountries OptometristsOptometrists OphthalmologistsOphthalmologists

Australia Australia 12.5 3.312.5 3.3 Canada Canada 10.26 3.310.26 3.3 U.K U.K 13.27 1.0613.27 1.06 New Zealand New Zealand 10 210 2 USA USA 10.99 5.710.99 5.7 India India 0.65 2 0.65 2 Ratio for 100000 people (per 0.1mill)Ratio for 100000 people (per 0.1mill) (source Dr.Hofstetter in WCO monthly (source Dr.Hofstetter in WCO monthly

bulletin)bulletin)



OPTOMETRISTS to OPTOMETRISTS to OPHTHALMOLOGISTSOPHTHALMOLOGISTS

Blindness Blindness New Zealand= blind: popu= 0.003 per millNew Zealand= blind: popu= 0.003 per mill India= blind: popu =0.012 per millIndia= blind: popu =0.012 per mill India has 4 times more blind per mill.India has 4 times more blind per mill.

Countries Countries Optometrists Ophthalmologists Optometrists Ophthalmologists

New Zealand (Pop 4.4mil)New Zealand (Pop 4.4mil) 10 10 22

India (Pop 1210mil) India (Pop 1210mil) 0.65 0.65 2 2 Ratio for 100000 people (per 0.1mill)Ratio for 100000 people (per 0.1mill)



Universities: Time line Universities: Time line (IOF)(IOF)

Our internal timeline target=No Our internal timeline target=No university will offer less than 4 year university will offer less than 4 year course in optometry by 2020 course in optometry by 2020 (grandfather (grandfather clause till then)clause till then)

Draft Common-minimum optometry Draft Common-minimum optometry curriculum & bridge courses to curriculum & bridge courses to upgrade 2 year diploma to 4 year upgrade 2 year diploma to 4 year degree is degree is readyready

Several universities are now accepting Several universities are now accepting lateral entrylateral entry



The IVI projectThe IVI project

India Vision Institute India Vision Institute (IVI) (IVI) inaugurated on oct.18,2011inaugurated on oct.18,2011

Task force set up to look into Task force set up to look into optimizing existing human optimizing existing human resources and developing resources and developing new professionalsnew professionals

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What will IVI do ?What will IVI do ?

An enthusiastic plan for the An enthusiastic plan for the development of optometry & development of optometry & vision industry over 5 yearsvision industry over 5 years Develop human resourcesDevelop human resources Ensure fundamental infrastructure Ensure fundamental infrastructure

is in placeis in place Establishing professional and Establishing professional and

regulatory framework for regulatory framework for optometryoptometry



IVIIVI PhD scholarship available within IndiaPhD scholarship available within India On our agenda specialties likeOn our agenda specialties like

Contact lensesContact lenses Low & assistive vision devicesLow & assistive vision devices RehabilitationRehabilitation Paediatric optometryPaediatric optometry

2



Opportunity for the Opportunity for the industryindustry

The global vision and eye care industry The global vision and eye care industry is worth approximately $89 billion in is worth approximately $89 billion in retail product salesretail product sales

$180 billion including professional fees$180 billion including professional fees India’s vision industry sits at a modest India’s vision industry sits at a modest

1% of the world’s consumption and is 1% of the world’s consumption and is valued at $5 billion at the retail levelvalued at $5 billion at the retail level

Yet India has 17% of the world’s Yet India has 17% of the world’s populationpopulation



Opportunity for allOpportunity for all

PartnershipPartnership between between Educational institutions + Educational institutions + optometry + corporate optometry + corporate world will lead to a win-win world will lead to a win-win situation for all three & also situation for all three & also for the country,hospitals & for the country,hospitals & societysociety



Availability of Availability of optometry education in optometry education in

India India 119 recognized universities/ 119 recognized universities/ institutions offer institutions offer optometry optometry coursescourses

65 Offer 3 or 4 year 65 Offer 3 or 4 year graduategraduate level programlevel program

16 offer 16 offer M.OptomM.Optom 4 offer 4 offer Ph.D.Ph.D. program program 4 Optometrists in India are at 4 Optometrists in India are at

““ProfessorProfessor” level” level



Indian optometrists are Indian optometrists are no less on international no less on international

standardsstandards 44 out of 253 44 out of 253 FIACLEFIACLE s in world are s in world are herehere

Lot of international Lot of international researchresearch (esp. (esp. CCLRU/BHVI, LVPE) is done by Indian CCLRU/BHVI, LVPE) is done by Indian optometristsoptometrists

Our optometrist has received a Our optometrist has received a PadmasreePadmasree

We hold a national/international We hold a national/international conferenceconference every year every year

As As facultyfaculty in foreign universities…… in foreign universities……

Does anybody know of

another professi

on

that has g

rown to th

is

level with

out being

recognized by Govt.?



Regulation through a councilRegulation through a council

We require support from the We require support from the Government to form a Council.Government to form a Council.

Meanwhile, in the interim period, Meanwhile, in the interim period, we are in the process of we are in the process of creating a creating a self-regulatory body self-regulatory body that will act as a council.that will act as a council.

2



Our wish-list..Our wish-list..

We wish to serve the people We wish to serve the people ““Freely and fullyFreely and fully””

We need a councilWe need a council Actually, now Actually, now IndiaIndia needs a needs a

council of optometrycouncil of optometry We request the government to make We request the government to make

use of existing professionals & use of existing professionals & avoid re-inventing the wheelavoid re-inventing the wheel



The day is not far..The day is not far..

When optometry in India will When optometry in India will have similar place as in have similar place as in developed countries like developed countries like Australia & USAAustralia & USA

The country needs Optometry The country needs Optometry &&

Optometrists Optometrists stand ready & stand ready & motivated to motivated to

meet the meet the challenge ofchallenge ofRight to SightRight to Sight

in India by 2020 in India by 2020



My contact details:My contact details:

Rajesh WadhwaRajesh [email protected]

9868010187www.indianoptometryfederation.org

Thank You!

Documents

Optometry in India- Optom. Rajesh Wadhwa M.Optom B.Ophth.Tech.(Hons.) AIIMS B.Sc.(Hons.) DU Fellow of International Association of Contact Lens Educators